Eye Drop Techniques from Dr. Andrew Iwach

I offer this piece of advice to my patients. It is helpful to acknowledge that some patients have a strong reflex that makes them blink at even the thought of the drop hitting their eye.

I suggest lying down flat, face up. Close your eye. Place the drop outside of the lid in the corner of the eye near the nose. As you open your eye, the drop will roll in. Then close the eye again. Don’t blink. Keep the eye closed for a few minutes.

Can eye drops really cause significant side effects?

The tears of the eye drain through a small canal into the nose. The inside of the nose is lined with nasal mucosa, which is vascular - it has many blood vessels.

When you put drops in your eye, the drops can become “pumped” into the tear system if you blink. Once in contact with the vascular nasal mucosa, relatively rapid absorption of drugs into the bloodstream can occur. The drops can act as a systemic “bolus” - an infusion of the drug into the bloodstream.

To minimize systemic effects and maximize local absorption into the eye, simply keep the eyelid gently closed for a few minutes after putting drops in.

So then, if your eye is closed, how do you know the time is up? You can use a cooking timer. Or, consider that most popular songs are 2-3 minutes long. Have the radio on when you put in your drops. After two songs, you can open your eye.

Many patients have found this a good alternative to punctual occlusion.

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Article by Andrew G. Iwach, MD, Associate Clinical Professor of Ophthalmology at the University of San Francisco and a faculty instructor at the California Pacific Medical Center Department of Ophthalmology.